Curing Utah's 'silent epidemic'

Finding a solution to teen suicide

By Benjamin Wood , Deseret News

Published: Sunday, Feb. 24 2013 5:40 p.m. MST

David Phan's father, Nhuan Phan, left, is emotional during a press conference about David Phan, a young man who shot and killed himself on an overpass near Bennion Junior High, on Sunday, Dec. 2, 2012. (Scott G Winterton, Deseret News)

SALT LAKE CITY — In 1997, Greg Hudnall was contacted by police and asked to identify the body of a student who had committed suicide near the school where Hudnall served as principal.

"It was the most traumatizing thing I've ever gone through," Hudnall said. "I walked back to my car and threw up and sobbed for probably an hour. Driving home I made a promise to myself that I would try to do something to prevent suicide in my school."

Suicide is the second-leading cause of death for Utah's youth and each day, two children ages 10-17 are treated for suicide attempts, according to the Utah Department of Health.

The harrowing facts about Utah's mental health, particularly among children, has motivated several state lawmakers to address the issue head-on this year. Rep. Steven Eliason, R-Sandy, has described suicide in Utah as a "silent epidemic" and has introduced legislation that would require school districts to hold annual parent seminars on suicide prevention, bullying and internet safety.

Bennion Junior High student David Phan, 14, shot and killed himself in front of schoolmates on a pedestrian skybridge Thursday, Nov. 29, 2012. (, Granite School District)

Sen. Luz Robles, D-Salt Lake City, worked with the family of David Phan to draft SB184, which would require schools to notify parents if a student threatens to commit suicide or is involved in an incident of harassment, bullying, cyber-bullying or hazing. Phan shot himself in front of several classmates on a pedestrian overpass near Bennion Junior High School in November. Reports from friends and family members suggest he was the victim of frequent bullying.

Robles said the current requirement to notify parents is broad and has led to some inconsistencies in the way districts apply the policy. In the case of David Phan, there is some dispute between the family and Granite School District as to how much and what information was relayed to the family prior to his death.

"It was heartbreaking to see parents saying that they were never notified," Robles said. "Somehow there was a miscommunication."

Robles' bill – as well as a nearly identical House bill sponsored by Rep. Gage Froerer, R-Huntsville – would set a statewide standard for when schools are required to contact parents about safety threats to their child. It would seek to get ahead of a problem before it claims the life of a child and also ensure that parents understand the gravity of what is being reported to them by requiring parents to sign a statement acknowledging that they were informed of an incident by educators.

On Tuesday, after the Senate Education Committee unanimously advanced Robles' bill, Phan's family released a statement expressing their thanks to the lawmakers who sponsored suicide prevention and anti-bullying bills.

"We are grateful that David's memory and the tragedy that our family is surviving are being addressed," the family said in a prepared statement. "Our family is pleased that the people of Utah have taken the issue of bullying seriously and have moved our legislature to bring anti-bullying legislation to the floors of both the House and Senate."

But with Utah's rate of suicide among the highest in the nation, the question remains as to whether a phone call home is enough to avert tragedy.

Next steps

Hudnall, who now serves as associate superintendent of Provo School District, said that contacting parents about concerns is a crucial and necessary first step, but effective suicide prevention can't stop there. During the past decade and a half since his experience in 1997, Hudnall has been instrumental in creating the Utah County HOPE Task Force, a comprehensive partnership between educators, law enforcement officials, mental health professionals and community organizations geared toward getting students the help they need.

"For us it's a multi-faceted approach and suicide is not an option because we work diligently with agencies and community volunteers," he said. "We believe it takes a whole village to save a child."

The task force, which is comprised of some 40 different agencies, got its start in 1997 after Hudnall sent out invitations to various organizations to participate in a round-table discussion on suicide. Nearly every group he contacted sent a representative and over several years, and after extensive dialogue, strategies were devised and plans were formed.

Between 1999 and 2005, Hudnall said there were between one and two youth suicides in Provo each year as the group grew and coalesced. In 2005 the task force seemed to hit a critical mass and since then, Hudnall said, there have been several suicide attempts and many hospitalizations, but not one youth's life has been lost to suicide in all of Provo School District and Provo City.

"This is our eighth year," he said. "We keep trying to put out the word. It's not a focus on suicide prevention, it's a focus on getting help for kids."

Finding solutions

Several of the task force's practices mirror recent action on the state level. For example, every teacher in Provo School District is required to go through suicide prevention training, similar to a bill passed last year requiring Utah's educators to undergo training every five years.

Provo district also holds a series of events aimed at training parents and community members to identify the warning signs of bullying and suicide, not unlike Eliason's bill requiring an annual parent seminar on suicide, bullying and internet safety.

But the HOPE Task Force, which stands for Hold On, Persuade and Empower, employs a greater breadth and depth than most school district communities and the state as a whole. Hudnall said the task force works with businesses and religious organizations to train parents, clergy and youth leaders and the school district hosts suicide walks and informational community events on an ongoing and nearly perpetual basis.

"We've trained 16,000 people so far throughout the community and throughout the area," he said. "We literally talk about it all the time. It's a proactive approach and everybody is involved."

In addition, free support groups are offered for at-risk students as well as the families of children lost to suicide. Inside the schools, HOPE Squads comprised of peer students are trained to watch out for warning signs and provide help and support to their classmates.

"They’re not therapists, they’re just support," Hudnall said. "They reach out, they listen, they know when to encourage kids to get to adults."

And if a student expresses a suicide threat, the school goes beyond contacting their parents, collaborating with school-assigned police officers to transport the student directly to the emergency room for a mental health evaluation.

"Before we would just call the parents and say you need to do something about it," Hudnall said. "Now, the school resource officer will 'pink slip' them and we literally take them to the hospital and have the parents meet us there."

Find the warning signs

Rebecca Glather, executive director of the Utah branch of the National Alliance on Mental Illness, said that the majority of individuals who suffer from mental illness begin to experience their symptoms between the ages of 14 and 24. This presents challenges, she said, because those ages coincide with the time when a person develops the academic, professional and relationship skills that they carry into their adult life.

If a child's parent is able to identify warning signs and intervene early on in the manifestation of a mental illness, she said, it can change the trajectory of that child's life. But Glather said it can be difficult to differentiate between emotional stress and normal teen angst as well as find adequate treatment, particularly in rural areas.

"We have a huge gaping hole in the center of our state where there are zero child psychiatrists," she said. "Treatment is a challenge."

Hudnall said the collaboration with mental health providers is the key component of the HOPE Task Force's success. He said to be truly effective, a school district needs to be able to immediately secure counseling for an at-risk student, a process which takes a significant amount of time and discussion with interested parties to put in place.

"It took us five to seven years to put it together," he said. "We didn't do it overnight. This is hundreds and hundreds of hours."

Glather said she was not familiar enough with the HOPE model to comment specifically on it's efficacy, but she praised the way the task force had built a comprehensive partnership to address the issue.

"Certainly the idea of bringing the community partners together and talking about how we solve this in our community is a good model," she said. "Everyone needs to be on board and look at what works and what the research says."

Puzzle pieces

Robles said her bill is only a piece of the ultimate puzzle of curbing Utah's suicide problem. She said the death of children is a family, community and state issue that will require continued discussion and work, but a crucial first step is making sure that initial collaboration – the one between parent and school – is taking place.

"The reality is we have a crisis," she said. "I don't know that we can overestimate the problem."

Hudnall had a similar view of the issue, saying that while he believes most school districts already strive to keep parents informed, a law reinforcing that practice would certainly not harm the suicide prevention process.

"Anything we can do to prevent suicide, I'm for," he said. "I'm sure that we will never do enough."

Glather also said that for parents who may be questioning whether their child's behavior warrants treatment, the standard criteria is when there is an interruption to daily life, such as oversleeping or insomnia, a sudden decline in academic performance or a loss of interest in activities they used to enjoy.

"Any time it gets to the point that it's interrupting their daily activity, their ability to engage in activities in their daily life, that's when parents should consider contacting a professional," she said.

How to get help

According to Greg Hudnall, a key focus of the Utah County HOPE Task Force's mission to prevent suicide is educating individuals about what resources are available to them and where to go for mental health services.

Here are some of the national and local agencies that provide assistance to persons experiencing emotional stress and suicidal thoughts.